At a Glance - Orbital cellulitis vs periorbital cellulitis

Orbital cellulitis

Orbital cellulitis causes eye movement to be restricted and painful


Discriminatory signs

  • Infection of the orbital soft tissues without abscess.
  • Lid oedema may be cool and not tender.
  • Involves eyelids, eyebrows and cheeks.
  • Caused by a bacterial infection from a stye, the sinuses, or via injury to the eyelid.
  • Fever.
  • Painful swelling of eyelids.
  • Eyelid appears shiny and red or purple in colour.
  • Systemically unwell.
  • Eye movements restricted and painful.
  • Swollen lid impairs vision and prevents eye from opening.
  • Bulging eyes.


  • Refer patient for IV antibiotics.


Periorbital cellulitis does not lead to any visual impairment

Discriminatory signs

  • Also known as preseptal cellulitis.
    Affects the eyelids and skin around the eyes, but not the orbit of the eye.
  • Lid oedema is warm and tender.
  • There is no visual loss, conjunctival oedema or protrusion of the eyeball.
  • Patient is afebrile and appears systemically well.
  • Tender, erythematous and swollen eyelids.
  • Can spread to the orbit.
  • Usually affects children.


  • Oral antibiotics.

Text contributed by Dr Vasa Gnanapragasam, a GP in Sutton, Surrey.

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